History of Therapeutic Guidelines

The beginnings

Therapeutic Guidelines have evolved out of activities dating back to January 1978 when a group of enthusiastic individuals came together to develop Antibiotic Guidelines in response to the worrying and emerging problem of antibiotic resistance.

Antibiotic Guidelines, a set of helpful and practical guidelines on appropriate and cost-effective antibiotic therapy, was a milestone in 1978. It had many virtues. Most importantly, it assisted in clinical decision-making and teaching, but it also became a standard against which prescribing of antibiotics in hospitals could be measured. It had just 31 pages, dealt with 59 indications and recommended use of 31 antibiotics. Specifically designed to fit into a doctor’s white coat pocket, 1000 copies were printed and distributed free of charge to all resident medical staff in Victoria’s public hospitals.

By 1994, other major therapeutic areas were covered in five additional guideline publications: Analgesic (1988), Psychotropic (1989),Cardiovascular (1991), Gastrointestinal (1994), and Respiratory (1994).

Establishment of Therapeutic Guidelines Limited – the company

By 1996, with guideline activities maturing rapidly and fast becoming part of the medical culture, Therapeutic Guidelines Limited (TGL) was established. Over the next 11 years, more titles were added to the series of Therapeutic Guidelines:Neurology (1997),Endocrinology (1997), Dermatology (1999), Palliative Care (2001), Rheumatology (2006) and Oral and Dental (2007).

Three additional titles were published over this period as well; Management Guidelines: Developmental Disability (1998),Understanding, Influencing and Evaluating Drug Use (2001), and Health Care and Notions of Risk (2004).

In response to the growing role of information technology in society, TGL allocated significant resources to the development of electronic versions of its texts. In 2002, all the Therapeutic Guidelines were integrated into a single product, eTG complete, which allows simultaneous searching across all content. In developing this electronic product, TGL researched many issues surrounding electronic publication, including format, and the design, structure, navigation and style of online information. Following on from this in 2005, all the eTG complete content was reworked for an offline product designed specifically for handheld devices, miniTG.

Demand for eTG complete and miniTG grew quickly and hospitals, libraries, training and health care providers were soon purchasing licences for eTG complete for intranets and networks; these groups comprise a large proportion of users today.

Continuing this growth, emergency medicine topics were added, greatly expanding the range of information. Many of these emergency medicine topics were published in the print title Toxicology & Wilderness (2008). Ulcer and Wound Management was published electronically and in print title in 2012. All of the topics and titles undergo regular review and revision prior to new versions being published.

Today, TGL offers a comprehensive series of Guidelines which are embraced and valued by users in Australia and overseas.

Therapeutic Guidelines Limited – Interactive timeline

Click here to access Therapeutic Guidelines’ history timeline highlighting key events and milestones over four decades of guideline development.

Content development process

The process used to develop the Guidelines has been refined over this 30-year history. The selection of content is driven by needs, with common medical problems being the fundamental guiding principle. For these, the best available scientific evidence is identified and working drafts are prepared. During the writing process, a series of day-long, face-to-face meetings are held, during which national experts analyse, debate and challenge all content. The experience, insight and opinions of these experts is fundamental to the process to ensure that the final texts truly represent an independent and expert interpretation of the evidence in clinical context.